1985. Atypical Symptoms and High Mortality Associated With Serogroup B Meningococcal Disease in Cartagena Colombia 2012–2016

Abstract

BackgroundMeningococcal disease occurs in an endemic or epidemic form, such as meningitis or meningococcemia, the latter being a fast and high disease, mainly in children. Atypical symptoms have been described by the serogroup W. The aim of this study was to determine the clinical and epidemiological characteristics of invasive meningococcal disease (IMD) by serogroup B and the factors associated with mortality in the Cartagena, Colombia between 2012 and 2016.MethodsCross-sectional study, carried out from 2012 to 2016 in patients diagnosed with meningococcal disease. Measures of central tendency and dispersion were calculated. A bivariate analysis was performed comparing deceased patients with survivors.ResultsFrom January 2012 to December 2016, a total of 41 cases were reported: one suspected, seven probable, and 33 confirmed cases (all serogroup B), which 73.2% were male, average age 17.9 ± 19.16 years old. Mortality was 39% (16/41), 68.7% (11/16) did it in the first 24 hours. Atypical symptoms were 51.21% (21/41): vomiting 48.7%, myalgias in the lower extremities 36.5%, abdominal pain 19.5% and diarrhea 17.0%, necrotic lesions 12.1%, cyanosis 31.7%, cough 12.1% and rhinorrhea 14.6%. And among the typical symptoms: fever 90.2%, drowsiness 70.7%, purpuric rash 60.9%, headache 53.6%, seizure 14.6%, photophobia 4.8%, psychomotor agitation 21.9%, neck stiffness 29.2% and gait deficit 17.0%. When comparing deceased with surviving cases, significant differences were found in abdominal pain OR 6.0 [1.18–40.27], neck stiffness OR 0.08 [0.009–0.74], meningococcemia OR 8.90, [1.66–47.75] and myocarditis OR 3.08 [1.93 -490), leukocytosis OR 0.22 [IC95% 0.05–0.88]), and PCR OR 0.24 [0.06–0.94]. The most prevalent serotype and sero-subtype was B: 10.15: nt (60.0%). Cluster A, with clonal complex ST-41/44 in 64.3%.ConclusionAtypical gastrointestinal manifestations, besides being described by serogroup W, may also be a form of presentation of serogroup B, related to a higher mortality.Disclosures All authors: No reported disclosures.